No office rate
G0413 addresses an iliac ring fracture; G0412 is specific to an iliac spine fracture.
On this page
CMS RVU26D · Effective 2026-10-01
G0412 Iliac spine repair Medicare reimbursement rates in Iowa
Open surgical treatment of an iliac spine fracture, reported when the fracture is treated through an operative approach on one or both sides. Compare G0412 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for G0412 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$603.54
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About G0412: Open treatment of iliac spine fracture
Open surgical treatment of an iliac spine fracture, reported when the fracture is treated through an operative approach on one or both sides.
An orthopedic or trauma surgeon uses an open operative approach to expose and treat an iliac spine fracture. A displaced anterior iliac spine avulsion that requires operative treatment is a representative clinical situation. The service addresses the iliac spine fracture itself, rather than a broader pelvic ring injury, and is generally performed in an operating room, usually in a hospital or other facility setting.
Report G0412 for open treatment of an iliac spine fracture, whether unilateral or bilateral. The operative report should identify the fracture location, side or sides, open approach, and treatment performed. Do not append modifier 50; CMS identifies bilateral adjustment as inappropriate for this descriptor. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. An assistant at surgery may be paid, and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for G0412
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.19 · 51%
- Practice expense (office) RVU7.67 · 38%
- Malpractice RVU2.17 · 11%
87
Medicare services in 2024 · #4987 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
G0412 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
G0414 is for an anterior pelvic ring fracture, not an isolated iliac spine fracture.
No office rate
G0415 is for a posterior pelvic ring fracture; G0412 applies to open treatment of an iliac spine fracture.
Compare G0412 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$603.54
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for G0412 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
15,241
- Code
- G0412
- Physician work
- 10.19
- Practice expense
- 7.67
- Malpractice
- 2.17
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.19 | × 1.000 | 10.1900 |
| Practice expense | 7.67 | × 0.915 | 7.0181 |
| Malpractice | 2.17 | × 0.397 | 0.8615 |
| Total RVUs | 18.0695 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$603.54
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.19 | 1 |
| Practice expense | 7.67 | 0.915 |
| Malpractice | 2.17 | 0.397 |
(10.19 × 1 + 7.67 × 0.915 + 2.17 × 0.397) × $33.4009 = $603.54
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
G0412 billing questions
How does G0412 differ from open treatment of a pelvic ring fracture?
G0412 is for a fracture of an iliac spine. Use a pelvic ring fracture code when the treated fracture involves the pelvic ring rather than the iliac spine.
Should modifier 50 be appended for bilateral iliac spine treatment?
No. The code covers unilateral or bilateral treatment, and CMS identifies bilateral adjustment as inappropriate for this descriptor.
What documentation supports G0412?
Document the iliac spine fracture, the side or sides treated, the open approach, and the treatment performed.
Are related postoperative visits separately included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and permits co-surgeons. Team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
15,238G0409,,Corf related serv 15 mins ea,R,,0.00,0.71,,0.71,NA,0.01,0.72,0.72,9,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,239G0410,,Grp psych php/iop 45-50,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,240G0411,,Interactive grp psyc php/iop,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,241G0412,,Open tx iliac spine uni/bil,A,,10.19,7.67,NA,7.67,,2.17,20.03,20.03,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,242G0413,,Pelvic ring fracture uni/bil,A,,15.34,10.68,NA,10.68,,3.26,29.28,29.28,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,243G0414,,Pelvic ring fx treat int fix,A,,14.28,10.35,NA,10.35,,3.04,27.67,27.67,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,244G0415,,Open tx post pelvic fxcture,A,,20.41,12.26,NA,12.26,,4.43,37.10,37.10,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136